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HFMA CRCR EXAM PREP NEWEST 2025 TEST BANK|
COMPLETE 400 ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREAD Y GRADED A+| HFMA CRCR
EXAM PREP| BRAND NEW!!
Any healthcare insurance plan that provides or ensures comprehensive health maintenance and treatment services for an enrolled group of persons based on a monthly fee is known as a
a) MSO
b) HMO
c) PPO
d) GPO - Correct Answer - B
Which of the following is NOT contained in a collection agency agreement?
a) A clear understanding that the provider retains ownership of any
outsourced activities
b) Specific language as to who will pay legal fees, if needed
c) An annual renewal clause
d) A mutual hold-harmless clause - Correct Answer - D
Maintaining routine contact with the health plan or liability payer, making sure all required information is provided and all needed approvals are obtained is the responsibility of: 1 / 4
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a) Patient Accounts
b) Managed Care Contract Staff
c) HIM staff
d) Case Management - Correct Answer - D
What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare?
a) Revenue codes
b) Correct Part A and B procedural codes
c) The CMS 1500 Part B attachment
d) Medical necessity documentation - Correct Answer - A
Before classifying and subsequently writing off an account to financial assistance or bad debt, the hospital must establish policy, define appropriate criteria, implement procedures for identifying and
processing accounts:
a) Monitor compliance
b) Have the account triaged for any partial payment possibilities
c) Assist in arranging for a commercial bank loan
d) Obtain the patients income tax statements from the prior 2 years -
Correct Answer - A
For routine scenarios, such as patients with insurance coverage or a
known ability to pay, financial discussions:
a) Are optional 2 / 4
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b) Should take place between the patient or guarantor and properly
trained provider representatives
c) May take place between the patient and discharge planning
d) Are focused on verifying required third-party payer information -
Correct Answer - B
The purpose of a financial report is to:
a) Provide a public record, if requested
b) Present financial information to decision makers
c) Prepare tax documents
d) Monitor expenses - Correct Answer - B
What type of account adjustment results from the patient's unwillingness to pay a self- pay balance?
a) Charity adjustment
b) Bad debt adjustment
c) Contractual adjustment
d) Administrative adjustment - Correct Answer - B
All of the following are conditions that disqualify a procedure or service from being paid for by Medicare EXCEPT
a) Medically unnecessary
b) Not delivered in a Medicare licensed care setting
c) Offered in an outpatient setting 3 / 4
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d) Services and procedures that are custodial in nature - Correct Answer
- D
All of the following are forms of hospital payment contracting EXCEPT
a) Contracted Rebating
b) Per Diem Payment
c) Fixed Contracting
d) Bundled Payment - Correct Answer - A
Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation?
a) Registration staff may routinely contact managed are plans for prior
authorizations before the patient is seen by the on-duty physician
b) Initial registration activities may occur so long as these activities do
not delay treatment or suggest that treatment with not be provided to uninsured individuals
c) Co-payments may be collected at the time of service once the medical
screening and stabilization activities are completed
d) Signage must be posted where it can be easily seen and read by
patients - Correct Answer – A
A claim is denied for the following reasons, EXCEPT:
a) The health plan cannot identify the subscriber
b) The frequency of service was outside the coverage timeline
c) The submitted claim does not have the physician’s signature
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